POS0445 MORTALITY TRENDS AMONG RHEUMATOID ARTHRITIS PATIENTS IN WESTERN AUSTRALIA
Authors: K. Almutairi, C. Inderjeeth, D. Preen, H. Keen, J. Nossent
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Mortality rates for patients with Rheumatoid Arthritis (RA) have reportedly improved in the past decades due to increasing access to specialised rheumatology care [1], early introduction of DMARDs with combination regimens [2], and subsequent biologics therapies [3]. However, the mortality rate remains higher than the general population, reducing the life expectancy by approximately ten years [4-5]. With scarce comparative data on mortality in Australian RA patients, we investigated temporal changes in standardised mortality rates for RA patients using longitudinal linked population-wide health data in Western Australia (WA) over the period 1980 to 2015. <h3>Objectives</h3> The aim of the study to estimate temporal standardised mortality rates over a 35-year period and identified leading causes of death and measured median Years Lost in a large RA cohort. <h3>Methods</h3> The study included 17,125 patients with a first-time hospital contact for RA (ICD-10-AM M05.00–M06.99 and ICD-9-AM 714) in the study period. Standardised mortality rate ratios (SMRRs) for the RA cohort versus the WA general population was estimated using direct age standardisation. We analysed temporal trends over death dates, causes from the WA death registry, and measured median Years of Life Lost by subtracting an individual's death age from their remaining life expectancy based on the Australian Government Actuary Life Table. <h3>Results</h3> Over the study period, SMRR was 2.5-folds (95%CI: 2.52-2.65) higher for RA patients than for the general population (Table 1), with a sex- and age-specific SMRR of 2.24 (95%CI 2.15–2.34) in males and 3.09 (95%CI 3.00–3.19) in females (Figure 1). The overall leading causes of death were diseases of the circulatory system, except among 30-44-year-olds in the 1991–2000 period, neoplasm was the leading cause of death. The median life years lost for the RA cohort were 5.7 years for females and 5.1 years for males over the study period (Table 1). <h3>Conclusion</h3> The mortality rate in RA patients in WA has decreased but remains higher than in Australian population. Malignant neoplasms were the second leading causes of death, and lung cancer was leading cause of cancer mortality. Together these data demonstrate the importance of screening and management for comorbidities in RA patients, especially cancer. <h3>References</h3> [1]Björnådal L, Baecklund E, Yin L, Granath F, Klareskog L, Ekbom A. Decreasing mortality in patients with rheumatoid arthritis: results from a large population based cohort in Sweden, 1964-95. The Journal of rheumatology 2002;29(5):906-12. [2]Kremers HM, Nicola P, Crowson CS, O'Fallon WM, Gabriel SE. Therapeutic strategies in rheumatoid arthritis over a 40-year period. The Journal of rheumatology 2004;31(12):2366-73. [3]Carmona L, Descalzo MA, Perez-Pampin E, et al. All-cause and cause-specific mortality in rheumatoid arthritis are not greater than expected when treated with tumour necrosis factor antagonists. Ann. Rheum. Dis. 2007;66(7):880-5. [4]van den Hoek J, Boshuizen HC, Roorda LD, et al. Mortality in patients with rheumatoid arthritis: a 15-year prospective cohort study. Rheumatol. Int. 2017;37(4):487-93. [5]Lassere M, Rietbergen M, Rappo J, et al. Mortality Its Predictors In Patients With Rheumatoid Arthritis. Intern. Med. J. 2004;34(11):A113. <h3>Acknowledgements</h3> The authors thank the data custodians of Hospital Morbidity Data Collection, Emergency Department Data Collection, the Death Registrations and staff at the Western Australian Data Linkage Branch to assist in the provision of data. Special thanks to the University of Western Australia to support KA with an Australian Government Research Training Program PhD Scholarship and the Australian Rheumatology Association WA for Research Fellowship Award. <h3>Disclosure of Interests</h3> Khalid Almutairi: None declared, Charles Inderjeeth Speakers bureau: Eli Lilly, David Preen: None declared, Helen Keen Speakers bureau: Pfizer Australia and Abbvie Australia, Johannes Nossent Speakers bureau: Janssen.